Bedsores is the common name used for Pressure or decubitus ulcers and commonly occur at heels, elbows, hips, knees, ankles, sacrum, coccyx etc. Bedsores usually occur because of continuous pressure applied for months (or even years in some cases) on the soft tissues present in the body. Pressure ulcers are very common in persons who don’t need any movement at work and who are living their life in wheel chairs. In general, bedsores occur on skin that coves the bony structure of the body. In elder people, bed sores develop very quickly and often very difficult to treat also.
- Immobility due to paralysis, coma, sedation, spinal card related problems, illness that force continuous wheel chair use may cause bedsores.
- Skin losses its strength with age. One can easily observe that skin is fragile and less elastic in older people and this increases the risk of getting bedsores.
- Dry skin increases the friction. Even people who don’t have bladder control face bedsores because of heavy friction between the body and clothes. One needs to strike the balance between the two.
- Poor nutrition can also be the reason for bedsores. Vitamins, minerals, proteins, fluids etc are compulsory for healthy skin and lack of one item can also decrease life span of tissues resulting in bedsores.
- Other medical problems like diabetes, vascular diseases can cause bedsores as they obstruct regular blood flow.
- Smoking causes life threatening health risks like cancer, breathing problems etc. Smoking can also cause bedsores as it obstructs the blood flow resulting in less oxygen supply.
- People who don’t have active state of mind are more prone to bedsores as they are unable to do actions that prevent bedsores.
- Bowel incontinence can also cause bedsores. This is a special case where the bacteria present in fecal matter damages the tissues present in the body and in some cases the infection spreads to whole body and become life threatening.
Bedsores are classified into one of the four stages based on their severity. According to NPUAP, a professional organization which strives to create awareness about pressure ulcers defined each stage as follows.
Stage 1 : The skin above the infected area is not broken and appears to tender and firm when compared to the surrounding area. The skin above the bedsore affected area usually changes to red color in light skin colored people and in dark skinned people the skin may appear discolored and peeling of outer layer of skin is not easy.
Stage 2 : The wound appears like fluid filled blister and the color of the wound changes to red or pink. The outer layer of the skin is damaged in this stage and the inner layer of skin is ruptured. One can observe a shiny or dry ulcer in this stage.
Stage 3 : One can view the carter like ulcer and some fat may get exposed and dead tissues (which will be in yellow or pale white color) can also be seen and the damage can extend beyond the layers of the skin. Heavy pain is observed whenever you tried to move the part where bedsore occurred.
Stage 4 : This is the last stage of bedsores and the damage is not confined to the layers of the skin. The dead tissues which are in yellow or black color can be seen and the bone or muscle will be exposed if the wound explodes. The damage for skin cells is severe in this stage and this stage is occurs only if the patient neglects heavy pain during stage 3.
Pressure on soft tissues which obstructs the blood flow to that area and the nearby areas is one of the important reasons and immobility that can cause severe damage to the tissues present in the buttocks and tailbone areas is other important reason. Here is the list of three important reasons that cause bedsores.
- Pressure : When the skin got trapped between the hard surface and the bones present in the body; capillaries which carry blood to deliver oxygen to the tissues cannot deliver sufficient amount of oxygen to the tissues and the tissues eventually die. Bedsores caused by pressure are usually seen in spine, elbow, hips, shoulder blades, knees etc.
- Friction : Bedsores due to friction are generally seen in people whose life is confined to wheel chairs. Care taker usually drags the patient (instead of lifting) and this causes friction between the skin and bones and finally leads to bedsores
- Shear : When one part of your body is stagnant and layer covering it is moving then it will cause bedsores. The best example for this kind of bedsores is sliding down from the elevated bed and the tail bone will be suffered and bedsores appear.
Whenever you approach the doctor the doctor will do following things
- Observing the wound to get an idea about size and depth of the ulcer.
- Checking for dead tissues near the wound
- Checking the area around the wound so that he can observe the spreading of tissue damage.
- Checking the fluids, debris, bleeding in the wound to get an idea about infections.
Apart from the above, doctors may recommend tissue culture checks to determine the severity of the bedsores. If the doctors have some doubt in mind, they may cut some skin near the wound and will check for cancer cells. They even recommend regular blood test to check your health.
If the wound is not responding to the treatment, doctor may opt for surgery so that the infection won’t spread to other parts and the chances to get cancer are reduced. Bed sores healing typically require so much time; in some cases healing process may continue for nine months to one year also.
- If you are using a wheel chair, try to change you position for every hour and change your weight from one side of your body to other side for every fifteen minutes.
- Even while sleeping also, try to reposition yourself frequently.
- Inspect all the body parts periodically and be hygienic.
Bedsores are classified as type 1 to type 4 based on their severity. Other classifications include based on the body parts where the bedsores occurred. In this classification, spinal card pressure sores are considered more severe when compared to other bedsores.
Bedsores can cause deaths and amputation of critical parts in rare occasions. If proper care is taken, bedsores won’t occur and even if they occur also, one can easily detect them in early stages and proper treatment can be provided.
- Be active at your work place and involve in some physical activity daily.
- Quit smoking.
- Have balanced and healthy diet.
If the wound is in stage 1 or stage 2 conditions, the wound can be cured and usually two weeks to several moths time period is needed to completely cure based on the severity of the wound. Stage 3 and stage 4 bedsores are difficult to treat and one needs to be extra cautious if the wound reached advanced stages.
- The first step in the treatment of bedsores is reducing the pressure near to the bedsore wound and suggesting different comfortable positions to patients. This is known as repositioning in medical terms.
- Using support systems such as pillows, cushions so that the pressure on the wound get reduced.
- Doctors usually clean the wounds of bedsores to prevent further infection and dress it in such a way that it creates a barrier between normal tissue and the infected tissue.
- Bedsores cause severe pain and doctors usually prescribe some medicines to reduce pain and antibiotics to heal the wound quickly.